Alumni Dissertations

 

Alumni Dissertations

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  • Core Competency Model for the Family Planning Public Health Nurse

    Author:
    Caroline Hewitt
    Year of Dissertation:
    2012
    Program:
    Nursing Studies
    Advisor:
    Carol Roye
    Abstract:

    It is important to define competency for both individual and organizational performance. Without defining the competencies that are necessary for a given job, it is not possible to hire, train or evaluate workers with the requisite skills. Although competency models have been developed for the general public health workforce and adapted by various public health specialties, like public health nursing, competencies for the family planning (Title X) public health nurse have not been specified. For this study a competency model was developed through expert consensus using a three stage Delphi Method. Expert consensus was sought using an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities as well as commonly offered family planning clinical services. The 32 item survey was distributed electronically via SurveyMonkey®. The study results suggest that the Delphi Method was a successful technique through which to drive consensus amongst a panel of family planning experts. Panelist attrition was low, and participation robust resulting in the final 28 item model. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. Implications of this study relate to education/training, certification and workplace performance.

  • Motivational Factors, Professional Values and Associate Degree Nursing Students' Intent to Continue Their Formal Education: Application of Structural Equation Modeling

    Author:
    Unn Hidle
    Year of Dissertation:
    2011
    Program:
    Nursing Studies
    Advisor:
    Martha Velasco-Whetsell
    Abstract:

    The level of nursing education has been shown to influence nursing care with a direct correlation between higher nursing education and improved patient outcomes. However, only 16-20% of Associate Degree (AD) nurses return to school for a higher degree in nursing. Studies have focused on barriers why practicing AD nurses do not pursue further education, though, no study to date has looked at motivational factors for AD nursing students to continue education. This quantitative structural equation modeling (SEM) study investigates the relationship between motivational factors, professional values and the intent to continue formal post-AD nursing education for AD nursing students in their last semester. The framework for the study is based on the conceptual framework of Deci and Ryan's Self-Determination Theory (SDT), elements of a literature review, which provides linkages between intention to attain a post-AD nursing degree, motivational style, and professional values to create the theoretical framework. A sample of 62 AD nursing students in their last semester of nursing at major community colleges in New York City participated. Self-administered questionnaires included the Academic Motivation Scale (AMS C-28), the Nursing Professional Values Scale Revised (NPVS-R), and a personal questionnaire developed by the researcher. Data analysis showed that AD nursing students with high professional values were self-determined with high intrinsic motivation. The majority of AD nursing students intended to pursue further education, however, intrinsic motivation did not have a direct effect in their intent decisional process. Finally, professional values did not have a direct effect on intent to continue education, but indirectly, professional values were a supportive factor of intrinsic motivation. Implications of this study support the enhancement of professional values in the AD nursing curriculum. Additional factors in the intent decisional process, including extrinsic motivators, should be explored in future research.

  • Living With HIV Disease: A Phenomenological Study of a Group of Older Black/African American Women

    Author:
    Judith James-Borga
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Abstract LIVING WITH HIV DISEASE: A PHENOMENOLOGICAL STUDY OF A GROUP OF OLDER BLACK/AFRICAN AMERICAN WOMEN by Judith C James-Borga Adviser: Professor Keville Frederickson Black/African American women are disproportionately affected by human immunodeficiency virus (HIV) disease. The purpose of this study was to gain an in-depth understanding of the experiences of a group of lower socioeconomic, older Black/African American women, who were living with HIV disease. A purposive sample of ten participants was obtained and data was collected through unstructured interviews. Using the phenomenological stance of Merleau Ponty, and guided by van Manen's methodological processes, seven essential themes emerged: transcending adversity and becoming; using knowledge as empowerment; dealing with HIV stigma; concealing and revealing; tending to their emotional life; and caring for others while they themselves were being cared for. The meaning of living with HIV disease is a dynamic interrelated patterning process of these essential themes. The findings support Pamela Reed's theory of Self-Transcendence. Implications for nursing include: the urgent need for a paradigm shift that acknowledge the strengths of older Black/African American women; the need for the integration of sexual assessment and education on risk reduction and medication adherence into routine healthcare encounters; and for further research to expand the data base on strategies that older Black/African American women use to overcome diversity and live with HIV disease. Key Words: HIV; older Black/African American women; self-transcendence.

  • Reconciling Life Balance: A Grounded Theory Study of Overcoming Failure

    Author:
    Kathleen Karsten
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Barbara DiCiccio-Bloom
    Abstract:

    Academic failure has been described as endemic in nursing education. Although, associate degree nursing programs graduate the largest number of nurses each year, the on-time graduation rate is 59%. Every semester students fail nursing courses and are required to successfully repeat the course before they can progress in the nursing program. Students who re-take a failed course are often called "repeaters." This qualitative Grounded Theory research explored the process of overcoming failure and becoming a successful student repeater. This emergent mode grounded theory study applied qualitative analysis techniques to prospectively verify and refine this emergent concept by delineating dimensions embedded in overcoming failure. Through the constant comparative method of data analysis, selective and theoretical coding, the Grounded Theory Reconciling Life Balance emerged. Reconciling Life Balance represents the basic social-psychological process of nursing students who failed a course, repeated the course successfully and continued to complete their nursing program. Two substantive categories emerged from this data: 1) acknowledging, which included the concepts of the unexpected and failure and 2) becoming a successful repeater, which included the concepts of managing emotions, asking for help and adjusting their work-life balance. By focusing on human interaction and emotional connections, Reconciling Life Balance has the potential to transform current approaches to nursing education and facilitate student success.

  • An Investigation of the Relationship between Nursing Faculty Attitudes toward Culturally Diverse Patients and Transcultural Self-Efficacy

    Author:
    Emma Kontzamanis
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    This descriptive study was designed to examine the relationship between nursing faculty attitudes toward culturally diverse patients and transcultural self-efficacy (perceived confidence in performing transcultural nursing skills). Nursing faculty are the educators of the largest group of health care providers. As such, they can have the greatest impact on student development of cultural competence and the provision of culturally competent care which promotes positive patient outcomes. The Cultural Attitude Scale, the Transcultural Self-Efficay Tool, the Social Desirability Scale and a demographic information sheet were completed by a sample of nursing faculty (N = 65) from a large northeastern public college system. Psychometric evaluation of the instruments indicated reliability. Significant findings were that the older, longer licensed faculty had a more positive attitude toward the White and Asian patient and faculty who received their basic nursing education in the U.S. had a more negative attitude toward the Black patient. A decline in mean scores of attitude over the last 20 years indicated a more negative attitude toward culturally diverse patients. There was no difference in transcultural self-efficacy scores for faculty with formal and/or informal education in transcultural nursing and those with no formal or informal education in transcultural nursing. Recommendations for future research include investigating the variables separately, conducting qualitative and mixed method studies with faculty and instrument refinement and development.

  • Role Stress, Eating Behaviors, and Obesity in Clergy

    Author:
    Nancy Manister
    Year of Dissertation:
    2012
    Program:
    Nursing Studies
    Advisor:
    Eileen Gigliotti
    Abstract:

    Purpose: This study, based on The Neuman Systems Model (Neuman, 2011) and Kahn and colleagues (1964) Organizational Role Theory, examined the relations between role stress, eating behaviors, and obesity in Lutheran Church Missouri Synod clergy. Method: This was a randomized, cross sectional, web based study (N = 430), response rate 38%. Variables were measured by the Role Conflict and Ambiguity Scales (Rizzo, House, & Lirtzman, 1970); Emotional and Restrained Eating Behavior Scales of the Dutch Eating Behavior Questionnaire (Van Strien, Frijters, Bergers, & DeFares, 1986), and self-report of height and weight for BMI calculation. Findings: Obesity was high (overweight/obese 81.4%, obese 36.7%). Emotional eating behavior partially mediates the relation between role stress and obesity (∼ 77 - 78%), and restrained eating was not a mediator. In ancillary analysis, restrained eating was found to moderate the relation between emotional eating and obesity. Low social support was the most significant contributor to role stress (r = -.41, p < .0001), which was moderate. Conclusions: Emotional eating partially mediates the relation between role stress and obesity. Restrained eating appears to moderate the relation between emotional eating and obesity. Future studies should examine the relation between role stress and the ability, rather than the intent, to restrain eating. Regarding Neuman's model, revisions to tests of relations between the normal line of defense and core response were proposed.

  • The Lived Experiences of Dominican Women with Stage IV Breast Cancer

    Author:
    Alsacia Pacsi
    Year of Dissertation:
    2010
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    ABSTRACT The Lived Experiences of Dominican Women with Stage IV Breast Cancer by Alsacia Lorena Pacsi MS, RN, FNP, CEN, CCRN Background: The diagnosis of breast cancer, for most, elicits anxiety and fear due to the disease and treatment process which usually has a devastating effect on the person, both physically and emotionally. Would ethnicity change or modify this stereotypical response? This study was done to illuminate the perceptions of Dominican women living with Stage IV breast cancer. Methods: This phenomenological study explored the lived experiences of Dominican women diagnosed with Stage IV breast cancer (advanced breast cancer) using a purposive sample of convenience to illuminate the perceptions of Dominican women living with advanced breast cancer. Six second-generation United States (US) born women of Dominican immigrants, residing in the New York City (NYC) area, underwent face-to-face in-depth interviews. Each participant was interviewed once and data analyzed using the descriptive phenomenological method of Amadeo Giorgi. Results: The four essences that unfolded in this study were uncertainty, coping, loving, and believing. The overall meaning of the experience of Dominican women with Stage IV breast cancer is described as one of uncertainty and unknowing, accepting the diagnosis so that thinking results in positive changes and healthy choices, enjoying life through the meaningful participation in the lives of others and accepting support and trusting in God through prayer, faith and hope to create ever lasting memories for their children. The synthesis of the overall structure for these women is to `leave a legacy of love.' Interpretation of the overall meaning of the experience and structure aligned with Roy's Adaptation Model (RAM) philosophic principles of humanism and veritivity (Roy & Andrews, 2009). The overall meaning of the experience, as expressed by the participants, was translated to and aligned with these principles. Conclusions: Analyzing the results of this research, one can infer that adaptation for the Dominican woman does not mean an acceptance of their illness, on the contrary. Adaptation in this case is an impetus to build a new environment and a new legacy for their children. Future studies should be done using qualitative and quantitative methodology in order to further explore the phenomenon of parenting in this population. .

  • Becoming Someone Different: A Grounded Theory Study of How Nurses Integrate Pregnancy and Full Time Employment

    Author:
    Paul Quinn
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Barbara DiCicco-Bloom
    Abstract:

    In the United States, 40% of the contemporary nursing workforce is comprised of women of childbearing age, 65% of whom are employed full-time. Hence, the likelihood of pregnancy occurring for this population at some point in their employment is high. A holistic exploration of how nurses integrate pregnancy and full-time employment has been lacking. The purpose of this research was to explore how primiparous nurses managed pregnancy and full-time employment. Using a grounded theory approach, nurses who were pregnant and delivered their first baby, while employed full-time on 12-hour work shifts, provided a firsthand account of how they incorporated pregnancy with employment. Nurses, as social actors, experience many interactions in their workplace environment. The basic social process, becoming someone different, emerged to explain those interactions and allowed a substantive grounded theory to be developed. From that exploration, the researcher will present the basic social process, becoming someone different, and the four core categories that arose from the analysis: 1) looking different, feeling different - to explain how the physical and emotional changes of pregnancy result in nurses looking and feeling differently about themselves as nurses; 2) expectations while expecting - where the nurse, with previous experiences and ideas about what is expected of her and what she expects from others, changes how she sees herself, based upon her interactions in the workplace with her peers and coworkers; 3) connecting differently - explains how the nurse, while pregnant, develops new relationships and interactions with the people in her environment, specifically her peers, coworkers and patients, and 4) transitioning labor - where, despite challenges from interactions within the workplace from coworkers or tasks, the participant nurses began to focus on their eventual maternity leave and working as long as possible up to the time of delivery in order to prolong that maternity leave

  • AN INVESTIGATION OF THE RELATIONSHIP AMONG SOCIAL SUPPORT, MOTIVATION, PERCEIVED COMPETENCE, AND PURSUIT OF A BACCALAUREATE DEGREE AMONG ASSOCIATE DEGREE NURSE GRADUATES

    Author:
    Margaret Reilly
    Year of Dissertation:
    2012
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    The Institute of Medicine Reports of the last ten years highlight the increased complexity of health care and the need for new ways for health providers to respond. While other professional programs have adapted to the growing complexity of the healthcare system and implemented increased educational requirements for entry to practice, notably pharmacy and physical therapy, nursing has not, and remains the least educated among health professionals The growing trend towards a two year Associate Degree as the initial nursing education degree is increasing at the same time that patient needs are becoming more complicated and health care is becoming more complex. The changing environment of the healthcare system requires an adaptive response from nursing. There is a need to explore those factors that influence educational mobility towards pursuit of a baccalaureate degree among associate degree nurse graduates, the largest segment of the nursing workforce. This quantitative, non-experimental, cross-sectional descriptive study explored the relationship among social support, motivation, competence and the pursuit of a baccalaureate degree among associate degree nurse graduates. The Roy Adaptation Model was used to guide the research design and Self-Determination Theory was used in the interpretation. A sample of 267 associate degree nurses who graduated from the City University of New York between 1997 and 2007 participated in a computer assisted telephone survey. Questionnaires included the Medical Outcomes Social Support Survey, adapted versions of the Self-Regulation for Learning and Perceived Competence Questionnaires as well as some selected demographic questions. Significant predictors for pursuit of a baccalaureate in nursing degree among this population included younger age, non-Hispanic Black race, income range of $104K to $145K and autonomous regulation of learning. Significant differences were found in autonomous regulation and perceived competence between those who did and those who did not pursue a BS. Social support was not a predictor, although it correctly classified 87% of those who pursued a baccalaureate degree.

  • The Relationship of Work Stressors and Perceived Organizational Support on Front Line Nurse Manager Work Engagement

    Author:
    Anne Marie Simmons
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Donna Nickitas
    Abstract:

    Abstract The purpose of this study was to examine the relationship of work stressors and perceived organizational support on front line nurse manager work engagement. A non-experimental descriptive, cross sectional design examined the relationship in a convenience sample of 97 front line nurse managers from the New York tri-state area and members of the American Organization of Nurse Executives. Instruments used to measure work engagement, work stressors and perceived organizational support, were: (1) the Utrecht Work Engagement Scale (UWES); (2) Challenge-Hindrance Stressor Scale and (3) Survey of Perceived Organizational Support (SPOS). Pearson's correlation and linear regression analyses indicated support for the relationship between all variables. There was a negative direct relationship between work engagement and work stressors and a positive significant relationship between perceived organizational support and work engagement. The conceptual framework of Kahn's work engagement and the Job Demands-Resources Model revealed that organizational support is needed to promote front line nurse manager work engagement. Work engagement, perceived organizational support and work stressors are professional environmental factors that impact the leadership and well-being of FLNM. These factors, properly promoted and implemented, lead to FLNM's success, retention and job performance.